Spinal Stenosis: Occupational Therapy Recommendations

Spinal stenosis occurs when the spinal canal, containing the spinal cord located in the middle of the spine, narrows causing pressure to be placed on one or more of the spinal nerves or cord. This condition usually occurs in the lower spine (lumbar) region and may be caused by arthritis, herniated disk, physical injury, spinal defect, tumors or aging. Treatment can include physical and/or occupational therapy, epidural or spinal nerve block injections, or surgery.

Symptoms

• Symptoms of spinal stenosis include numbness in the lower extremities; limping; cramping; pain in the lower back, buttocks or legs; impaired gait; sciatic nerve pain; and feelings of heaviness. Symptoms usually will worsen when walking or standing for longer periods of time. They may tend to lessen or disappear when leaning forward or in a sitting position. Individuals displaying the early symptoms of spinal stenosis may be encouraged to curtail their physical activity or prescribed mild analgesics, or arthritis or anti-inflammatory medications. Unfortunately, spinal stenosis will worsen with time.

Occupational Therapy

• Very often, the medical professional will recommend that an individual diagnosed with spinal stenosis participate in occupational therapy to increase functional independence in activities of daily living. Occupational therapy helps patients who have trouble doing daily tasks learn skills for bathing, dressing, cooking, eating or driving while promoting emotional well-being, independence and an enhanced quality of life. Often combined with physical therapy, programs can be structured, goal-oriented and customized to meet an individual's needs.

Therapist Evaluation

• An occupational therapist will perform an initial evaluation to determine the patient's general health, past medical history, baseline skill level, strengths, limitations and degree of independent activity. Physical limitations that will be evaluated include impaired balance, leg pain, environmental barriers (both in the home and work place), equilibrium factors and weakened lower extremity strength. The therapist may include therapeutic activities, exercise, simulated work tasks and equipment designed to assist the patient with his/her physical mobility such as a shower chair, non-slip mat, cane, walker, shoe horn or grab bars.

Recommendations/Suggestions

• After the therapist has completed her evaluations, recommendations and suggestions will be made to assist and educate the individual living with spinal stenosis. Exercises and activities will be suggested to improve the patient's strength and endurance. Modifications and alterations will be made to the home and work environment to improve safety and efficiency factors. Individuals will also be educated on adapting activities of daily life including cooking, shopping, cleaning and home management.